When the papers and the TV were full of pictures of junior doctors over the weekend, I’m sure there were a lot of people up and down the country asking themselves, ‘what’s a junior doctor?’
I know you know who we are and what we do. My point is that lots of people don’t. We might do better than apiarists or stenographers, but it’s that word ‘junior’ that causes the confusion.
Its root is from the Latin for ‘young’, and in the eyes of some of our patients and colleagues, we will be forever young, even if our experience, qualifications and the bags under our eyes suggest otherwise.
Yes, inevitably, some of us are fresh out of university, but even then it’s after five years of intense study, and in just a year of medical practice, we often feel we have learned more than in those previous five. And there are junior doctors with 10 times that experience on the wards, with more letters after their names than a ‘senior’ in just about any profession, running clinics, operating, dispensing, referring… you know what you do.
So why does this matter? It matters because we want the public to understand the issues in our fight for a fair and safe contract, and these issues make more sense if they understand the way we work.
Some people, for example, think our constant learning is much more about ‘seeing’ than ‘doing’. The fact that it’s overwhelmingly ‘doing’, that we provide a huge amount of the care that takes place in the NHS, means that our need for safe working hours is all the greater. Exhausted observers are inefficient, exhausted practitioners can be dangerous.
Sometimes we have to fill the natural gaps in people’s knowledge, but we are battling not only against this but also a deliberate campaign of misinformation. In particular, there are those who would conflate our concerns about the new contract with the ongoing political clamour for seven-day working. We already do it, we always have, and when these bizarre and annoying stories crop up in the Sunday papers, thousands of us are too busy at work to read and refute them.
Of course, we don’t want the public’s perception of us to swing to the opposite extreme, that all doctors are the same. We are all at various stages of our training: some of us are months away from being consultants, others are just a few months out of medical school – and all points in between. Consultants teach us and support us from a position of greater experience. It’s very important for patients to know that this support is as much for them as it is for us.
And it could be worse. Barristers technically remain ‘juniors’ until they become QCs. Many never do and some remain ‘junior’ to those several decades their younger. They do tend to get paid more than us though.
So what’s the solution? We could try to encourage the use of the words that distinguish between junior doctors, like ‘foundation doctor’ and ‘specialty registrar’. But these definitions tend to shift over time, and the survival of ‘SHO’, years after the term fell out of official usage, suggests we don’t even like the official terminology, never mind wish to promote it. The Royal College of Psychiatrists is debating and have strong support for renaming medical staff in psychiatry.
‘Junior doctor’ will probably have to suffice until we find a better way of describing ourselves. The priority instead is to stress what all junior doctors do for their patients. They carry responsibilities and make the kind of decisions on a day-to-day basis that many other people only have to shoulder on a few occasions in their lifetime. They have ambitions and qualifications, but they also frequently have kids and mortgages. They have ordinary needs, but often face extraordinary situations.
So next time you hear someone complain they were ‘only seen by a junior doctor’, don’t get cross. Try to share with them a little of what makes our jobs so incredible. The public already likes us – that’s been made abundantly clear in the last few weeks. But the more they also understand us, the more they will support our fight for justice.
Zead Said is an ST5 in general adult psychiatry in south Yorkshire
Find out more about the junior doctors' contract
The first part of this article gets to the crux of the matter - the NHS uses "junior" doctors to deliver service rather than focussing on training them to deliver specialist level care at an earlier stage. A Canadian resident spends 4 years after medical school to achieve specialist training in Internal medicine, 3 or 5 in emergency medicine, 5 or 6 in surgery, 2 years in family medicine, and 4 years in paediatrics. I'm sure the UK royal colleges would not say that Canadians are smarter than British trainees? No, rather, perhaps it is because they have one to one training clinically, and much more of the service commitment is delivered by specialists/consultants. Having moved from the NHS to Canada 6 years ago, I now truly believe that the UK government needs to recognize that it is safer and more cost efficient to employ more consultants, to deliver a 24/7 NHS. And consultants, being one of a team of 26 physicians, even with night shifts, beats being on call 1 in 6.
The term Junior doctor is confusing and so is doctor in training for the public. I am sure many of us have had patients who understood these terms to be equal to medical student.
Essentially a junior doctor is a trainee consultant.
Why not call ourselves that?
My own mother did not realise that I am a junior doctor! This illustrates your point that the public do not understand who we are and what we do.
Well said, very true indeed, the hard work and sacrifice medical students go through deserves a recognition.
As a member of the public I found this was a very informative read. Could you clarify if all Junior Doctor's are hospital based. Do GP's, for example, count as Junior Doctors?
GP's are not considered to be junior doctors as they have completed all their training in "general practice" and are fully independent medical practitioners as is a hospital consultant. Those training to become GP's would be considered junior doctors, as would be a person training in the hospital who is yet to become a consultant.
Hope that helps,
Technically, I'm a junior doctor, but I will no longer be using that title.
Having completed my training, and entered on the specialist register, I am a:
As foundation doctors are rotated into different posts, my Foundation Doctor colleagues are:
DOCTORS IN POST
As trainees are training to be a specialist in a specialty, my trainee colleagues are:
DOCTORS IN SPECIALTIES
My consultant colleagues are:
My GP colleagues are:
Not one of the people i work with are junior. They have differing degrees of experience and skill, but not one of them are junior.
Junior Doctors are wonderful, they have given a great deal to become Doctors. We should all be grateful to have them in this Country . They could be paid more and treated better in other countries. Not have a Government that make them appear money seeking and lazy. Please support them.
How about calling doctors reaching the registrar position being called doctors not junior doctors. If we dont it means that unless you become a consultantant no matter how long you have been a doctor you are still deemed junior. It is stupid!!!
I don't get the difference between a junior and a student doctor.